How much do my breasts weigh? It's an odd question, but one I was forced to contemplate a few months ago when my surgeon informed me my breast tissue would be weighed post-mastectomy to help determine the size of my final implants.
Bilateral mastectomy. Tissue flaps. Expanders. Implants. While I was familiar with all these terms after having witnessed my mother battle breast cancer, they were words that, until recently, I had not imagined would apply to me so soon. I am only 38 and I do not have breast cancer.
What I do have is a BRCA1 mutation that translates into a roughly 95 per cent lifetime risk of getting breast cancer. For me, it was not a question of if I get breast cancer, but when.
It has been almost nine years since my mother was first diagnosed. The words ovarian cancer came as a shock to all of us. No one else in her family had ever had ovarian cancer, so my mother thought perhaps it was a result of the hormone replacement therapy she had used during menopause.
Once genetic counsellors were involved, it became clear that while ovarian cancer was not evident in the past generations of our family, breast cancer was, and the two cancers are inextricably linked. A picture soon emerged from the branches of my maternal grandfather's family tree that pointed to a genetic component to my mother's cancer.
Two years ago, it was confirmed that both my sister and I were carriers of a little-known BRCA1 mutation. In the time since I found out I carried a microscopic remnant from the past, my mother's own legacy continued on its predetermined path. Two instances of breast cancer were found a year apart. She underwent first radiation, then a double mastectomy that was nothing short of torturous in the recovery phase. All we could do was stand by and pray for a good outcome.
For BRCA1 carriers, or "pre-vivors" as we are sometimes known, there is no perfect solution but there are imperfect ones. Doctors have no way of stopping the onset of breast cancer, but they do have good ways of finding it. Mammograms, breast MRIs, ultrasounds and biopsies became a regular part of my life.
The more I thought about my options, however, the more I realized I would prefer never to hear the words, "You have breast cancer," even if the doctors could detect it early enough to save my life. I have seen what chemo and radiation do and how sometimes the cure can be as bad as the disease.
After living in the shadow of cancer for long enough, I decided to undergo a preventive double mastectomy. I was shocked at the thought of it the first time a physician presented it as an option. I loved my breasts in all their imperfect, midlife glory. They were a sign of my femininity and my sexuality; they nourished my three beautiful babies. I'm young, I thought, too young to have to worry about cancer.
But the truth is I'm not too young, and while I don't have a crystal ball I have been given a partial view of what my future holds.
It has been almost three months since my surgery. I wish I could say it went off without a hitch, but I have now added terms such as flap necrosis to my lexicon. It has been a difficult recovery with many tears shed, but not all of them in sadness.
What has allowed me to get beyond the intense pain and the emotional ups and downs of my recovery is the overwhelming kindness heaped upon me from near and far. Messages filled my inbox with expressions of love and support; my family and friends came from across the country and around the world to look after me; and my husband has held me steady and kept his eye on what the future holds.
To this end, and to provide some much-needed comic relief, my husband has been honing his artistic skills. When bandages were still covering my open wounds 10 weeks out of surgery, Brent would pull out a Sharpie in a colour chosen by the children - "Purple this time!" - and draw nipples on the bright white gauze.
He reasoned we should experiment to determine the best size and placement for new nipples. This way, when my second round of surgery is complete and I have my new, permanent, nippleless "foobs" (fake boobs), we will be able to tell the tattoo artist exactly what we would like her to do to complete the reconstruction process.
I now know how much my breasts weighed: 400 grams each. Nearly a kilo was taken off my chest, but the weight that was removed from my mind is immeasurable.
Lara Shecter lives in Vancouver.
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